Abstract 13194: Regional Disparities in Clinical and Socioeconomic Characteristics of African-American Patients With Cardiac Amyloidosis Served by Two Inner City Hospitals

Abstract

Introduction: The highest prevalence of cardiac amyloidosis (CA) in the United States (US) is reported among African American (AA) individuals, with a significant regional variation in this prevalence. We aimed to study the clinical, demographic and socioeconomic differences among AA patients diagnosed with CA from inner city hospital located in different regions of the US. Methods: Demographic, clinical and socioeconomic data on patients diagnosed with CA was collected from Buffalo General Medical Center, Buffalo, NY (Northeast region; Erie County) and Cook County Health, Chicago, NY (Midwest region; Cook County). CA was diagnosed based on a combination of pyrophosphate scintigraphy and assessment of paraproteinemia. Socio-economic data from zip code of patient’s residence was obtained from publicly available 2010 census summary data. Results: Overall, 80 patients were tested for CA in Erie County and 150 patients in Cook County, of which 58 (72.5%) and 128 (85.3%) were AA, respectively. Among AA patients, 16 (28%) from Erie County and 29 (23%) from Cook County were diagnosed with CA (Table). Despite younger age, and a lower prevalence of male gender, CAD, hypertension and aortic stenosis, Cook County patients had more severe cardiomyopathy, given a significantly lower ejection fraction at presentation. Additionally, patients from Cook County had lower socioeconomic status as evident by a lower average income, fewer social security beneficiaries, greater unemployment and a greater prevalence of uninsured population. Conclusions: Despite similar racial background, there are significant demographic, clinical and socioeconomic differences among AA patients with CA from two different regions in the US. Within race disparities, that could be influenced by regional socioeconomic differences, may drive clinical outcomes of AA patients with CA.